A case of pregnancy-associated acute myocardial infarction with refractory ventricular fibrillation and heart failure. Issue 1 (July 2016)

• Record Type: Journal Article
• Authors: Hasegawa, Tomoya; Tabata, Hiroaki; Kagoshima, Mitsuru; Okada, Hiroyuki; Aida, Hiroshi; Shoin, Wataru; Shoin, Kyoko; Ikeda, Uichi
• Is Part Of: Journal of cardiology cases. Volume 14:Issue 1(2016:Jul.)
• Page Start: 13
• Page End: 16
• Publication Date: 2016-07
• Subjects: Pregnancy-associated acute myocardial infarction -- Spontaneous coronary artery dissection -- Therapeutic hypothermia -- Cardiac arrest in pregnancy; Cardiology -- Periodicals; Cardiovascular Diseases -- Case Reports; Cardiovascular Diseases -- Periodicals; Cardiology -- Case Reports; Cardiology -- Periodicals; Cardiology; Electronic journals; Periodicals; 616.12
• DOI: 10.1016/j.jccase.2016.03.001
• Languages: English
• ISSNs: 1878-5409

Abstract

Abstract: Acute myocardial infarction (AMI) is rare among women of childbearing age. Spontaneous coronary artery dissection (SCAD), a rare cause of AMI, is the leading cause of pregnancy-associated acute myocardial infarction (PAMI), and is associated with critical complications, including pump failure, ventricular arrhythmias, and sudden death. Optimal treatment strategies for SCAD and PAMI remain unclear. In this report, we describe a case of PAMI due to SCAD presenting as cardiopulmonary arrest. After comprehensive treatment including advanced cardiovascular life support, emergent percutaneous coronary intervention (PCI), therapeutic hypothermia, and emergent Cesarian section for intrauterine fetal death, she survived without neurological sequelae. Intensive medication for pump failure was subsequently required, and she was discharged with adequately controlled heart failure, despite revealing stent lumen obstruction by cardiac computed tomography. On close follow-up for one year, she has remained free of further cardiac events. <Learning objective: Pregnancy-associated acute myocardial infarction (PAMI) is a rare but occasionally complicated event. Spontaneous coronary artery dissection is the principal mechanism of PAMI. The clinical presentation of PAMI can range from asymptomatic to cardiac shock and fatal ventricular fibrillation. We aimed to present a sudden cardiac arrest case due to PAMI. Intensive and comprehensive medical care succeeded in her return to spontaneous circulation and discharge without neurological sequelae.>